Mad in America: Rethinking Mental Health

In the face of the COVID pandemic, social and academic pressures, and an uncertain future, young people are struggling. Each week we see another news reports about a "mental health crisis" among youth in North America, including rising suicide rates. Last fall, a consortium of physicians declared poor youth mental health a "national emergency." More recently, on December 7, 2021, the U.S. Surgeon General issued an advisory on Protecting Youth Mental Health, which prescribes actions by families, schools, governments, media and other stakeholders. Typically, these announcements call for getting kids greater access to mental health diagnosis and treatment. As MIA readers know, that frequently leads to more screening, more labels, and more prescriptions for psychiatric drugs. In his practice with children and adolescents, his research, and his teaching, Dr. Elia Abi-Jaoude is pushing back on that approach in favor of alternatives that more closely involve families and take environmental elements into account. Here, he tell us why and shares how he works in his practice with youth in crisis. Elia Abi-Jaoude, MD, FRCP(C) is a psychiatrist working mainly with children, adolescents, and their families at The Hospital for Sick Children in Toronto, Canada, primarily in an inpatient setting. He is also an assistant professor, researcher, and clinical educator at the University of Toronto. Dr. Abi-Jaoude is interested in how social factors influence how we view the experiences of youth and in asking critical questions about some of psychiatry's assumptions about diagnosis and treatment, particularly the influence of the pharmaceutical industry. He is coauthor of a journal article taking a second look at the research behind the famous Study 329, which found that certain psychiatric drugs did not improve teenagers' depression symptoms better than no drugs, as had been claimed.

Sebastienne Grant is a professor of critical psychology at Prescott College in Prescott, Arizona. She currently serves as the program director for a Master's program in Critical Psychology and Human Services. Dr. Grant received her PhD in Psychology: Consciousness and Society from the University of West Georgia. Grounded in the traditions of Buddhism, critical psychology, existential-humanistic psychology, and transpersonal psychology, Dr. Grant is concerned with questions of wellbeing—both individual and societal. She has written on transhumanism from Buddhist and existential perspectives, as well as the tensions of social justice under neoliberalism. Her most recent publication is a chapter titled "Addressing the Empty Self: Toward Socially Just Subjectivities" in the book Subjectivity in Psychology in the Era of Social Justice. This book was co-written with several colleagues, including previous MIA podcast guest Dr. Bethany Morris.

Dawn Sonntag and Kermit Cole have collaborated on creating a 30-minute opera, For Life, that explores the possible harms that can come from psychiatric drugs. It's a novel subject for an opera, which premieres online on January 15 at 9 p.m. EST. The opera will be performed by students at the Baldwin Wallace Conservatory of Music. Dawn is an award-winning composer whose works have been commissioned by the Cleveland Opera Theater and the Hartford Opera Theater and performed at numerous music festivals in the United States and Canada. Her first opera, for which she also wrote the libretto, titled Verlorene Heimat, was a finalist in the 2021 American prize for opera. She wrote the composition for For Life. Kermit Cole is well known to Mad In America readers. He cofounded madinamerica.com, and served as our editor for the first four years. He has a background in street theatre, having toured Europe as part of a mime troupe, and in the 1990s, produced a documentary about living with HIV. He has worked in various residential settings for people struggling with psychiatric difficulties and is trained in Open Dialogue therapy. He wrote the libretto for the opera.

Vincenzo Di Nicola is an Italian-Canadian child and adolescent psychiatrist and a Professor of Psychiatry at the University of Montreal where he co-directs the postgraduate course in psychiatry and the humanities. He has written extensively about the importance of relationality and dialogue in therapy and is one of the leading figures of social psychiatry. Most recently, he received the 2022 Distinguished Service Award from the American Psychiatric Association. Di Nicola's most recent book Psychiatry in Crisis (co-authored with Drozdstoj Stoyanov) offers a critical analysis of the discipline and points to the glaring gaps that must be addressed.

In this podcast we discuss an educational program called Emotional CPR (eCPR), a form of peer support anyone can use to assist youth (or adults) in emotional crisis. Our guests are Oryx Cohen and Briza Gavidia of the National Empowerment Center, a Massachusetts-based nonprofit whose mission is to carry a message of recovery, empowerment, hope, and healing to people with lived experience with mental health issues, trauma, and/or extreme states. Oryx Cohen, M.P.A., is a leader in the international mental health consumer/survivor/ex-patient (c/s/x) or Mad Pride movement. Currently, Oryx is NEC's Chief Operating Officer. Among other responsibilities, he organizes the national Alternatives Conference every three years and assists states that have an underdeveloped consumer/survivor voice to find that voice and then work toward transforming their mental health systems to become peer-driven and recovery-oriented. Oryx is also a lead trainer for Emotional CPR, or eCPR, and has conducted over 50 eCPR trainings around the world. Prior to joining NEC, Oryx was Co-Director of the Western Massachusetts Recovery Learning Community. There, he helped to spearhead an innovative peer-run approach focusing on recovery, healing, and community. Oryx is also the co-founder of Freedom Center, the Pioneer Valley's only independent peer-run support/activist organization. Briza Gavidia is a certified Youth Emotional-CPR (eCPR) Educator. She is 21 years old and is a student at Fullerton College majoring in sociology. Briza is currently employed in a program assisting the elderly with daily activities. Her goal is to work in the mental health field so she can give young people real hope for a better future. She loves sharing her lived experiences with trauma and how she is tackling these challenges so she can become a stronger person.

Elisa Lacerda-Vandenborn, a professor at the Werklund School of Education, focuses on education and decolonization of mental health in Indigenous communities. She discusses the historical oppression faced by these peoples and critiques mainstream psychological practices for their lack of inclusivity. Lacerda-Vandenborn advocates for holistic, community-driven approaches like Family Group Conferencing, emphasizing the importance of cultural healing in child welfare. She underscores the need for ethical research methods that prioritize Indigenous voices and collective well-being.

On the Mad in America podcast this week, we hear from Renee Schuls-Jacobson. Renee was a teacher for two decades and she is now an author, artist, advocate and coach. In this interview, we discuss her book Psychiatrized: Waking up After a Decade of Bad Medicine which was released this year. The book is a beautifully written account of Renee's experiences being prescribed the benzodiazepine clonazepam (Klonopin) for seven years. It talks of her experiences taking the drug as prescribed but perhaps more importantly, also tells of what happened to Renee as she made attempts to withdraw.

In this podcast, we hear from the renowned clinician and researcher Dr. Giovanni Fava. Dr. Fava is a psychiatrist and professor of clinical psychology at the University of Bologna in Italy. He is also a clinical professor of psychiatry at the University at Buffalo School of Medicine and Biomedical Sciences. Since 1992, he has been the editor-in-chief of the peer-reviewed medical journal Psychotherapy and Psychosomatics. Dr. Fava has authored more than 500 scientific papers and is known for researching the adverse effects of antidepressant drugs. In a 1994 editorial, he argued that many of his fellow psychiatrists were too hesitant to question whether a given psychiatric treatment was more harmful than it was helpful. He recently released his latest book entitled "Discontinuing Antidepressant Medications" published by Oxford University Press. The book is designed to be a guide for clinicians who want to help patients withdraw from antidepressants. In this interview, we discuss the new book, approaches to antidepressant cessation and explore some of the concepts including novel psychotherapeutic approaches to withdrawal.

Hans Skott-Myhre is a Professor of Human Services at Kennesaw State University in Kennesaw, Georgia. Over the last 50 years, he has worked within a wide variety of human service settings, including residential homes, community health centers, inpatient psychiatric units, homeless youth shelters, transitional living programs, and prisons. About two decades ago, he transitioned into academia, where he now does research at the intersections of human services, psychology, cultural theory, and literature. His recently published book titled "Post-Capitalist Subjectivity in Literature and Anti-Psychiatry: Reconceptualizing the Self Beyond Capitalism" explored how we might be different types of people if we didn't live in a capitalist society. The book draws on Marxist and post-Marxist theory and presents a nuanced analysis of antipsychiatrists' professional writings, including Franco Basaglia and R. D. Laing, as well as the work of fiction writers, including Franz Kafka and Gabriel García Márquez. Through this analysis, Skott-Myhre identifies alternative conceptualizations of self and community that take us beyond capitalist subjectivity.

In this podcast, which comes on the heels of reports linking social media use to reduced self-esteem in teen girls, eating-disorders therapist Shira Collings discusses person-centered, socio-culturally aware approaches to dealing with disordered eating and other food-related challenges in youth (and adults). Shira Collings, M.S., N.C.C., is Mad in America's Assistant Editor for MIA Continuing Education and the Youth Coordinator for the National Empowerment Center. She received her B.A. in Communication from the University of Pennsylvania and an M.S. in Counseling and Psychology from Troy University. As a person with lived experience of recovery from diet culture, disordered eating, and trauma, Shira is passionate about supporting others in finding freedom with food, body acceptance, and the ability to be their full, authentic selves and live according to their values. She is an advocate for trauma-informed, person-centered approaches to mental health care.